The ultimate objective of this program project is to develop and implement interventions for the prevention and cessation of smokeless tobacco use based on an improved understanding of the health effects of smokeless tobacco. Five projects are proposed: (1) a study of smokeless tobacco use and clinically and histopathologically defined oral disease in profession baseball players, which includes intervention development; (2) a study of smokeless tobacco use and clinically and histopathologically defined oral disease in collegiate baseball players that will include follow-up, intervention development, and intervention piloting; (3) a controlled intervention trial of smokeless tobacco cessation methods among collegiate baseball players; (4) a study of physiologic effects of nicotine from smokeless tobacco use; and (5) a study of possible viral co-factors in oral lesions associated with smokeless tobacco use. Two core components will relate to all five projects: an Intervention Development and Testing Core (A) and a Scientific Leadership and Administrative Support Core (B). The various projects will share data (clinical measureZ01MH02395, biopsy materials, blood, saliva, the results of attempted intervention strategies) and use common resources (smokeless tobacco questionnaire, clinical examination protocol, cotinine and thiocyanate validation testing, histopathology review, and statistical analysis). All will contribute to the development and testing of interventions that incorporate relevant findings about the oral health and other physiologic effects of smokeless tobacco and that are acceptable and feasible for use among young men at high risk for smokeless tobacco exposure.